Friday, November 19, 2010

Started neuropsych evaluations

Over the next month, I will be doing a series of neuropsych evaluations at CEPD.  For some reason, they do one screening per day, unlike Columbia which had me do 8 hours of screening in one day.  Maybe the screenings will go better since I won't be as tired.  I won't have to travel 2+ hours to the Upper West Side of New York City.  I just roll out of my house and I am at CEPD in 15 minutes.  I was exhausted during my testing at Columbia.  The test administrator had allowed me to snack during the test and I ate a bunch of snacks and drinking caffeinated ice tea in the afternoon just to keep focus.
Brainscan of brains with and without ADHDBrain Scans of People with ADHD Image via Wikipedia
The first test we did is the TOVA, test of variables of attention.  TOVA is often used to help diagnose ADHD.   I did the visual portion of the test and not the auditory one. The visual T.O.V.A. target is a square with a second but smaller square inside of it, near the upper border. The nontarget is a square with the smaller square near the lower border.  You press a special button when you see the target square near the upper border.

In the first half of the test (the target infrequent half), the target:nontarget ratio is 1:3.5, i.e.: a target is presented (randomly) only once every 3.5 nontarget presentations. This half of the test is designed to be boring and fatiguing and it was.  If you don't respond to the target, you commit an error of omission (a measure of inattention).

The second half of the test, (target frequent half), the target:nontarget ratio is 3.5:1, i.e: 3.5 targets are presented for every 1 nontarget. In the second half of the test, you are expected to respond most of the time but occasionally must inhibit the tendency to respond. If you  respond to the nontarget, it is called an error of commission and is a measure of impulsivity.

The ability to pay attention to a boring, repetitive task is best measured in the first half of the T.O.V.A. while the ability to inhibit oneself is best measured in the second half.

Other T.O.V.A. measures include variability of response time (consistency), response time, commission (impulsivity), errors of omission (inattention), post-commission response times, multiple and anticipatory responses, and an ADHD score, which is a comparison to an age/gender specific ADHD group.

 I was pretty stressed while taking the test and my tinnitus kicked up.  After the test,  I  took a break at my favorite coffee shop and did some window shopping afterwards to relax.

It will be interesting to see how the results of this test compare to the Connor's Continuous Performance Test that I took during my initial neuropsych evaluation.   The Connor's Continuous Performance Test had an X flash on the screen.  I was supposed to hit a key each time I saw the X and make sure I did not hit a key if something else flashed up on the screen.   I took this test in the afternoon and I remember missing a bunch of X's and mistakenly hitting the key.  I had a few variables that indicated some impulsivity but I didn't hit the level to indicate ADHD.

We shall see what the end result of all this is at the beginning of December.   Why does receiving the evaluation of the neuropsych exam take so long?  What are these people doing with themselves?  A lot of these exams are on the computer and there are enough computer programs out there to quickly slice and dice data.  So, what's the deal?  I don't know.

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